CORRELATION BETWEEN ATTITUDE OF UNIVERSITY STUDENTS TOWARD PEOPLE LIVING WITH HIV/AIDS AND WILLINGNESS TO INTERACT WITH

THEM

(PROJECT PROPOSAL) EXECUTIVE SUMMARY (MUSA_ NOR_19022093001)

The HIV epidemic has created a terrible burden for millions of individuals, families and communities worldwide. Relieving the suffering requires improved healthcare, better access to the treatment, more vigorous prevention efforts, more effective social outreach and support for those most vulnerable. However, stigma and discrimination blocks the march forward against HIV/AIDS. This project aims to address stigma and discrimination against people living with HIV/AIDs and formulate strategies / procedures / policies for improved management of these ill fated people so that their well-being can be improved. This project is combination of action research and situation analysis through a scientific study to understand various dynamics of management of HIV/AIDs patients, followed by formulation of strategies / procedures based on findings of study and application of appropriate interventions at various levels of stake holders. This study/project is spread over a period of two weeks. TABLE OF CONTENTS BACKGROUND RATIONALE STUDY/PROJECT GOALS OBJECTIVES RESEARCH QUESTIONS METHODOLOGY

STUDY/PROJECT SETTING STUDY/PROJECT DESIGN SAMPLING FRAME SAMPLE SIZE VARIABLES BUDGET BACKGROUND Acquired immunodeficiency syndrome (AIDS) is the terminal visible event in the sequence of occurrence beginning with the entry of the human immunodeficiency virus (HIV) in the host. The most common mode of HIV transmission is sexual contact, and sexual transmission has become the conventional explanation for the HIV epidemic in several parts of the world. Above all, nearly decade after infection HIV causes no noticeable signs of disease in the human host. Such HIV infected persons, termed silent carriers, represent an important component in the transmission cycle. During this asymptomatic time, the virus has ample opportunities to spread from one unsuspecting host to another, thereby ensuring its survival. Most often HIV moves from infected to susceptible people by vaginal or anal intercourse, exchange of blood, intra venous drug or from an infected mother to child. As a result, the HIV pandemics raised a number of social, behavioral, legal, ethical and moral issues. Management of HIV/AIDs is somewhat different from other diseases because, only clinical management is not sufficient, psychological and behavioral changes are also urgently needed to improve the well-being of those living with HIV/AIDs plus those that come into contact with them at different levels. HIV/AIDs well-being promotion strategies may include the following; (A) Education about HIV/AIDs. (C) Advocacy. (B) Assessment of Individual Needs. (D) Community Outreach and Education.

(E) Translation service.

(F) Coordination of Care Plan.

(G) Access to Medications and Clinical Trials. (H) Access to Mental Health Therapists. (I) Legal and Financial Assistance. (J) HIV voluntary Counseling and Testing Referrals (VCT). The management of AIDS also includes an intentional approach to remove certain barriers to compliance, such as, stigma and discrimination in different settings, especially in homes, schools, hospitals and other social settings. Stigma often leads to discrimination and this, in turn, leads to human rights violations for people living with HIV/AIDs and their families. Stigma and discrimination fuels the spread of HIV/AIDs epidemic. Such behaviors hamper prevention and care efforts by sustaining silence and denial about HIV/AIDs. This may reinforce the marginalization of people living with AIDs and particularly those who are vulnerable to HIV infection. Since HIV/AIDs is linked to social taboo, such as sex and drug use, there is an enormous level of disrespect, denial, fear and ignorance about the disease in most communities. This may partly be due to these fears and prejudices that people stigmatize and discriminate. Discrimination occurs when negative thoughts lead people or institution take, or omit to take, action that treats a person unfairly and unjustly on the basis of their presumed or actual HIV/AIDs status. Some examples of discrimination include hospitals or prison staff denying health services to a person living with HIV/AIDs; employers terminating worker from his/her job on the grounds of his/her actual or presumed HIV status; or families/ communities rejecting those living with, or believed to be living with, HIV/AIDs. A series of interviews published in the 2001 by health reviewers underscore concerns that doctors and nurses in public hospitals and clinics are major culprits discriminating against people with HIV/aids. Then a person with a sound mind would wonder. If a doctor who is supposed to preach against stigma and discrimination is the one promoting it in communities then what about millions of residents who have not received education or effective sensitization about the disease. Being tested without consent, broken confidentiality with HIV test results and callous treatment were some of complaints leveled by HIV positive patients against public health workers.

RATIONALE This study/project aims promoting well-being for all people living with aids in different social settings; like homes, schools, workplaces, hospitals where most of them seek medical advice. This study/project shall improvise core framework for any change/s at the institutional and individual levels and across all stakeholders that in turn shall help create an environment of understanding, empathy, love, trust, hope, human rights and dignity for those living patients living with HIV/AIDs. STUDY/PROJECT GOALS
y Educating the public and community regarding stigma and discrimination against people

living with HIV/AIDs.
y Encouraging communities to support people with AIDS. y Decrease stigma and discrimination against HIV/AIDs patients at home, workplace,

schools, healthcare and other social setting settings. OBJECTIVES
y To identify the factors leading to stigma, discrimination and human rights violations. y To identify the roles of individuals and institutions in contributing to stigma and

discrimination
y To increase self-awareness and understanding of individuals and institutions in hospital

and community settings to combat stigma and discrimination, towards people living with HIV/AIDs, their partners and families, as well as marginalized groups as a way to promote the well-being on those living with HIV/AIDs and those at different ecological levels .
y

To frame recommendations / interventions for policy makers and other influential groups for improvements in social wellbeing of HIV/AIDS patients and other stakeholders.

RESEARCH QUESTIONS 1. What are the factors leading to stigma and discrimination against people living with HIV/AIDs? 2. Who perpetuates discrimination against people living with HIV/AIDs? 3. What behaviors do people living with HIV/AIDs base on to determine their being stigmatized or discriminated? METHODOLOGY STUDY/PROJECT SETTING This study/project shall be based on major public and private hospitals and communities in city of Bandung west Java province, Indonesia. Duration of this study and project shall be approximately 2 weeks. STUDY/PROJECT DESIGN This study/project shall be based on interview, observation, questionnaires and literature review as instruments for data collection:
y In-depth interviews of communities, friends and relatives regarding HIV/AIDS patients. y Case studies of HIV/AIDS patients. y Review of policies and procedures, safeguarding patient¶s rights to confidentiality and

impartiality. SAMPLE FRAME Samples for this study shall be taken from different groups who may have varying degree of roles. These roles may be contributory to perpetuating stigma, discrimination and human rights violations and/or groups working, one way or other, to address the stigma, discrimination and issues arising thereof. The target groups identified as stake holders for this study/project are:

1. Healthcare workers, such as doctors, paramedics, nurses and orderlies. 2. People living with HIV/AIDS. 3. Organizations / Advocacy groups working in the field of HIV/AIDS. 4. The general public. 5. Teachers and students. 7. Journalists and media. SAMPLE SIZE
y At least 05 patients who are diagnosed as HIV positive. y 20 students, volunteers to people living with HIV/AIDs y

VARIABLES
y Demographic/personal information of patients, community and relatives. y Socio economic status of patients, friends and relatives. y Perceptions of healthcare providers, patients and communities about the disease. y Policies and procedures in different settings.

Anticipated problems and possible solutions
It¶s anticipated that a number of problems will be experienced especially during interview for example; 1) Some respondents will be difficult to contact as they have to attend lectures during day. 2) Negative responses will be expected to occur frequently from respondents due to fear of disclosing their HIV/AIDs status. 3) Inadequate data from HIV/AIDs students¶ organisations in the selected faculties.

The following are the solutions for the above mentioned problems;
1) To diminish this, permission or letter from university will be used as a measure to ensure confidence among the respondents .Alternatively, countless of respondents will be approached in order to compliment the required sample size.

2) Also to minimise on negative tendencies, confidentiality will be insured to the respondents by not disclosing their names, names of selected faculties. Predicted results and implications The study will lead to the contributions such as creating awareness, clear communication for an effective behavior change of agencies working towards combating HIV/AIDs infection in the country. Human rights approach as a measure to promote the well-being of those living with HIV/AIDs and those that discriminate them because of ignorance. The findings will be important to Indonesia ministry of health to take into account the

behaviors of the youths and will take the findings since at present they are focusing at 100% condom use among commercial sex workers only.